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Genetic and Environ...
Genetic and Environmental Factors and Cardiovascular Disease Risk in Adolescents
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- Ballin, Marcel (författare)
- Uppsala universitet,Klinisk geriatrik,Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden,Uppsala Univ, Sweden; Ctr Epidemiol & Community Med, Sweden
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- Neovius, Martin (författare)
- Karolinska Institutet
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- Ortega, Francisco B. (författare)
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain;Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland;CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Granada, Spain,Univ Granada, Spain; Univ Jyvaskyla, Finland; Inst Salud Carlos III, Spain
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- Henriksson, Pontus (författare)
- Linköpings universitet,Avdelningen för samhälle och hälsa,Medicinska fakulteten
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- Nordström, Anna (författare)
- Mittuniversitetet,Institutionen för hälsovetenskaper (HOV),Rehabilitation and Pain Centre, Uppsala University Hospital, Uppsala, Sweden; School of Sport Sciences, UiT the Arctic University of Norway, Tromsø, Norway; Department of Health Sciences, The Swedish Winter Sport Research Centre, Mid Sweden University, Östersund, Sweden,Swedish Winter Sport Research Centre,Uppsala Univ Hosp, Sweden; UiT Arctic Univ Norway, Norway; Mid Sweden Univ, Sweden
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- Berglind, Daniel (författare)
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden;Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden,Karolinska Inst, Sweden; Ctr Epidemiol & Community Med, Sweden
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- Nordström, Peter (författare)
- Uppsala universitet,Klinisk geriatrik,Uppsala Univ, Sweden
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- Ahlqvist, Viktor H. (författare)
- Karolinska Institutet
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(creator_code:org_t)
- American Medical Association (AMA), 2023
- 2023
- Engelska.
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Ingår i: JAMA Network Open. - : American Medical Association (AMA). - 2574-3805. ; 6:11
- Relaterad länk:
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://urn.kb.se/re...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Importance Cardiovascular risk factors in youth have been associated with future cardiovascular disease (CVD), but conventional observational studies are vulnerable to genetic and environmental confounding.Objective To examine the role of genetic and environmental factors shared by full siblings in the association of adolescent cardiovascular risk factors with future CVD.Design, Setting, and Participants This is a nationwide cohort study with full sibling comparisons. All men who underwent mandatory military conscription examinations in Sweden between 1972 and 1995 were followed up until December 31, 2016. Data analysis was performed from May 1 to November 10, 2022.Exposures Body mass index (BMI), cardiorespiratory fitness, blood pressure, handgrip strength, and a combined risk z score in late adolescence.Main Outcomes and Measures The primary outcome was fatal or nonfatal CVD, as recorded in the National Inpatient Register or the Cause of Death Register before 2017.Results A total of 1 138 833 men (mean [SD] age, 18.3 [0.8] years), of whom 463 995 were full brothers, were followed up for a median (IQR) of 32.1 (26.7-37.7) years, during which 48 606 experienced a CVD outcome (18 598 among full brothers). All risk factors were associated with CVD, but the effect of controlling for unobserved genetic and environmental factors shared by full siblings varied. In the sibling analysis, hazard ratios for CVD (top vs bottom decile) were 2.10 (95% CI, 1.90-2.32) for BMI, 0.77 (95% CI, 0.68-0.88) for cardiorespiratory fitness, 1.45 (95% CI, 1.32-1.60) for systolic blood pressure, 0.90 (95% CI, 0.82-0.99) for handgrip strength, and 2.19 (95% CI, 1.96-2.46) for the combined z score. The percentage attenuation in these hazard ratios in the sibling vs total cohort analysis ranged from 1.1% for handgrip strength to 40.0% for cardiorespiratory fitness. Consequently, in the sibling analysis, the difference in cumulative CVD incidence at age 60 years (top vs bottom decile) was 7.2% (95% CI, 5.9%-8.6%) for BMI and 1.8% (95% CI, 1.0%-2.5%) for cardiorespiratory fitness. Similarly, in the sibling analysis, hypothetically shifting everyone in the worst deciles of BMI to the middle decile would prevent 14.9% of CVD at age 60 years, whereas the corresponding number for cardiorespiratory fitness was 5.3%.Conclusions and Relevance In this Swedish national cohort study, cardiovascular risk factors in late adolescence, especially a high BMI, were important targets for CVD prevention, independently of unobserved genetic and environmental factors shared by full siblings. However, the role of adolescent cardiorespiratory fitness in CVD may have been overstated by conventional observational studies.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
Nyckelord
- Cardiology
- Kardiologi
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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